Vitamin D: The American Deficiency

Article Categories: Patient Education & Taking Care of Yourself

Got Vitamin D? Chances are, you don’t. Two-thirds of Americans are not getting enough of the “Sunshine Vitamin,” leading to serious health implications. Of course you know that it plays a key role, along with calcium, in preventing osteoporosis.

A lack of Vitamin D is also a factor in:

• Heart disease
• Dementia and cognitive deficits
• Severe asthma in children
• Diabetes and other autoimmune diseases
• Cancers: breast, colorectal, pancreatic, and prostate

The combination of more time spent indoors and use of sunscreen has contributed to the lack of proper blood levels of Vitamin D. The normal range, obtained by the 25-hydroxy vitamin D blood test, is currently 20 to 50 ng/ml, although experts disagree on the optimal blood level. The Institute of Medicine (IOM) suggests > 20ng/ml, based on bone health, while the Endocrine Society recommends a higher baseline of > 30ng/ml.

The natural way to boost Vitamin D levels is by sunlight exposure. Direct contact with the sun allows the skin to produce Vitamin D3 sulfate in a water-soluble form, making it able to travel freely in the circulatory system. In order to synthesize Vitamin D, the body needs UVB rays, which are present during mid-day from spring through autumn. (During winter, the sun’s rays are more indirect, preventing UVB rays from reaching the skin.) Depending on skin tone, sun exposure to arms and legs can be as short as six minutes, up to about ten minutes, just a few times a week. Darker skin tones will require more time, up to about twenty minutes. As with most medical topics, there is controversy regarding purposeful sun exposure versus the risk of skin cancer, so therapy should be discussed with a healthcare provider.

For individuals who prefer Vitamin D supplements, the current recommended dose is 400 IU a day, almost exactly what is in a teaspoon of cod liver oil. According to Mark A. Moyad, MD, MPH, in an article for “Dermatology Nursing,” 800-1000 IU a day may be more effective in achieving a blood level of 35-40ng/ml. Whenever possible, begin with a baseline Vitamin D level before starting a regime. It takes two to three months to raise the blood level. (Note: Healthcare professionals who work in clinics or don’t have access to laboratory testing can recommend 2000 IU per day, says Roberta Anding, MS, RD/LD, CDE, CSSD, Director of Sports Nutrition at Texas Children’s Hospital.)

For people who are overweight or obese, obtaining adequate Vitamin D levels can be challenging. Results of a recent meta-analysis of studies showed that when compared to a normal weight population, the prevalence of Vitamin D deficiency is 24% higher for those who are overweight and 35% higher for the obese. There is also evidence that sun exposure is not effective for these individuals. The World Health Organization (WHO) estimates that with the number of overweight and obese people skyrocketing around the world, the next ten years will bring a pandemic in Vitamin D deficiencies, accompanied by the diseases, conditions, and complications that will add to the burden of global healthcare.

Do you know your own Vitamin D level? If not, get one done and assess your risk, as well as what you can do to maintain an optimal level. Encourage your family, friends, patients, and colleagues to do the same. This essential nutrient will help keep your life full of “sunshine.”